This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Thursday, September 01, 2016

The Macro View – Health And Political News Relevant To E-Health And Health In General.

September 1 Edition.

The big issue for this week will be just how the politics will play out and what impact it will have as Parliament comes back with the new government in the next week (Starts Tuesday 30 August, 2016).

It seems that the News Limited papers have decided we are in for a big mess.

No sign of a government plan as we face need for reform amid global disruption

August 28, 2016 12:00am

Terry McCrann

WE are now almost two months since the election and parliament finally starts sitting next week.

More striking, thanks to the Prime Minister’s “inspired” idea of forcing a double dissolution and the longest election campaign in decades, government was “on hold” for fully two months before that.

The government unveiled a Budget way back at the start of May and then promptly went into “caretaker mode”.

We have had four months essentially without a functioning government.

That’s more than 10 per cent of the entire life of a government’s normal full three-year term.

OK, Malcolm Turnbull has done a couple of things; like having an overnight panic and calling a royal commission on the back of a dodgy ABC report. And then stuffing even that up.

And true also, the Treasurer did knock back the attempt by Chinese and Hong Kong companies to buy the NSW power grid. It might have saved the nation from a serious (undisclosed) security threat, but it also threw NSW’s infrastructure and budget plans into disarray.

The central problem, though, is does anybody believe the government at least “has a plan”? That, now at last the parliament is back, we’ll also get back to “government in action”?

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The major policy shift this week – and also backed by The Economist – is discussed here:

Peter Martin

Ever been the victim of a poorly specified target?

I used to be, for years, when I had to change trains. The timetable indicated that the next one would arrive a few minutes after the first. And it nearly always did, except that it often sped past without stopping. It had a target to meet.

Hospitals do it with waiting lists. Told to get them down, they find excuses to knock people of the listf, even if they are still waiting. Chief executives do it with share prices. Incentivised to get them up, they bring forward income, skimp on actually looking after their customers, and act surprised when things collapse. Dick Smith is an obvious recent example. The target - share price - has ended up driving the enterprise rather than what the target sought to achieve.

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This debate has a very long way to run

Looks like we are in for an interesting time in the next few months.

Most interesting is that the GG's speech had a lot on health and zilch on e-Heath. Wonder what is going on?

David Crowe

Coalition spending cuts are tipped to add $221 billion to the nation’s bottom line over more than a decade according to new claims that intensify pressure on Bill Shorten to stop “wobbling” on the issue and support more savings.

The federal government has produced the new estimate to ­assure voters that almost 800 spending cuts have already helped improve the budget balance — and that more savings can be found even if Labor tries to block them in parliament.

Finance Minister Mathias Cormann said last night that the decisions taken since the 2013 election would add $26bn to the budget balance over the next four years and would build over time by 2026.

“Put another way, if we had not made the decisions we have made over the past three years to reduce spending growth, our debt position would be increasing by about an additional $221bn over the next decade, with the related additional public debt interest burden which would come with that,” he said in a speech to the Sydney Institute.

IF YOUR latest wage rise was so small it left you convinced others must doing better, you probably are right.

Economic inequality is growing and its most serious consequence is not just to your pay packet. It’s affecting the entire nation’s well being, according to a high-powered report today.

Inequality is reducing economic growth and this could cost every Australian $500 a year each unless it is checked, said the report Inequality — the hidden headwind for economic growth, by the Inclusive Prosperity Commission of the Labor-aligned Chifley Research Centre.

It said the gap between rich and poor was restricting prosperity and the loss could be greater than the gains expected from the trade agreements with Japan, China and Korea combined.

Ross Gittins

There are a lot of nice people in the world, people who worry about all the debt we're leaving to our kids and grandkids. I know this from the letters I get from people.

I got an email from a retired couple who said they'd be happy to pay more – a 15 per cent goods and services tax, medical co-payments or even a 10 per cent increase in income tax – if only it was guaranteed that the money was spent "to pay down debt, not rack up more with populist promises".

Unfortunately, there are no nice people in politics. Or, if a few start out that way, they soon get it beaten out of them.

Last week, in his first big speech since he was re-elected – the one so rudely interrupted by some woman who thought the mistreatment of asylum seekers on remote islands was something worth drawing to our attention – Malcolm Turnbull decided to tug on the heartstrings of nice people everywhere.

Opposition leader Bill Shorten will try to put pressure back on the government over budget repair today by insisting it adopt more than $8 billion in Labor proposals, including curbs on negative gearing and scrapping plans to reintroduce a baby bonus.

When Parliament begins Tuesday, the government will demand the swift passage of a bill containing 21 spending cuts worth a combined $6.5 billion, which the Opposition pledged to support directly or in kind during the election campaign. Now, Labor is split over about one third of the savings.

Mr Shorten will tell the National Press Club on Wednesday his party will make a final decision when it sees the actual legislation. But he will argue budget repair should cut both ways and if the government were serious, it would adopt Labor's $8 billion in proposals as well.

"Both major parties want a stronger bottom line for the country. The current disagreement is how we get there," he will say.

The Treasurer is issuing a dire warning that Australia's national debt could reach one-trillion dollars within 10 years, if his budget savings don't pass parliament.

Treasurer Scott Morrison is concerned Australia's continued economic success has been steadily sowing the seeds of complacency.

The country is in its 25th year of consecutive economic growth, meaning a generation has grown up not ever having known a recession or an unemployment rate above 10 per cent with one million Australians out of work.

Mr Morrison will attempt to gain support from cross benchers today for his budget savings measures, warning that national debt could reach one trillion dollars if they don't pass parliament.

David Crowe

Australians face a new divide ­between “the taxed and the taxed-nots” as a generation grows up on welfare without paying tax, Scott Morrison will declare today in a dire warning about the action needed to prevent deeper deficits and an economic crisis.

In a dramatic move to sharpen the national debate on budget ­repair, the Treasurer will blast the “complacency” about government spending and economic growth when the nation faces the risk that it will “all go south” and end in recession.

“There is a new divide: the taxed and the taxed-nots,” Mr Morrison will say in a speech that prepares the ground for a fight on budget repair when parliament resumes next week.

“Deficits are dismissed as ­temporary, cyclic and self-correcting. If it means services are maintained, then deficits are OK — just increase the taxes or ­increase the debt.”

Treasurer Scott Morrison says Labor is stuck in a 1970s-type mindset when it comes to how people live and work and how it impacts their superannuation.

Opposition Leader Bill Shorten told the National Press Club he phoned Prime Minister Malcolm Turnbull on Wednesday offering the government an alternative plan to assist putting a $500,000 lifetime cap on non-concessional superannuation contributions.

Mr Turnbulll and Mr Morrison are facing opposition from the coalition backbench on the plan, with some even consider crossing the floor of parliament on the issue.

But Labor will also oppose three additional government super proposals which allow catch-up concessional superannuation contributions, harmonising contribution rules for those aged 65 to 74 and tax deductions for personal superannuation contributions.

Treasurer Scott Morrison will warn today that ongoing complacency over budget repair and economic reform could plunge the country into recession.

In a dramatic escalation of the economic debate, the Treasurer will lament what he believes is a growing and dangerous acceptance of increasing debt and deficit without regard for the eventual consequences.

"Deficits are dismissed as temporary, cyclical and self-correcting. If it means services are maintained, then deficits are OK, just increase the taxes or increase the debt," he will say in the first of a series of headline economic speeches planned over coming weeks.

James Massola

A generation of Australians has never known a recession or high unemployment but unless hard decisions are taken soon, there is a "terrible risk" complacency could end Australia's 25 consecutive years of economic growth, Treasurer Scott Morrison has warned.

In the first of three "economic headland" speeches the Treasurer will deliver in the coming weeks, designed to set out the budgetary challenges facing the nation - and the government's vision for how to tackle them - Mr Morrison will argue that it should not take an economic crisis to trigger a wake-up call, or restart the economic reform process, so Australia enjoys a prosperous future.

In extracts of the speech seen by Fairfax Media, which will be delivered in Sydney on Thursday, Mr Morrison made a simple plea.

Peter Martin

Now he tells us. Within days of his appointment as Treasurer last year Scott Morrison rashly assured us he faced "a spending problem, not a revenue problem".

Would he need to pull in more revenue? "I'm not in that camp," he told the ABC's Leigh Sales.

But he his now. In a speech that bookends the remarks he made a year ago this week on taking the job, he concedes he has "an earnings problem".

"Deficits have proven difficult to shift in recent years, despite applying significant expenditure controls," he told the Bloomberg Economic Summit in Sydney. "The situation has been made even worse by the budget sabotage engaged in by the opposition during the last Parliament and the unwillingness of the previous Senate to enable the government to implement our agenda for budget repair."

David Uren

Sarah Martin

Generous pay rises awarded to senior bureaucrats in the wake of the global financial crisis will boost their pensions by millions of dollars, as the government faces another massive blowout to the nation’s superannuation lia­bility, which soared by $80 billion to just under $250bn last year.

As the Turnbull government fights for its budget plan to impose $6bn in new superannuation taxes on Australians, benefits are continuing to accrue for those on ­generous public-service pension schemes, with the liability for taxpayers on track to balloon by tens of billions of dollars when final budget figures are released next month.

Although the major federal defined benefit schemes were closed to new members in 2005, they still have more than 350,000 members entitled to lifetime pensions based on a portion of their final salaries.

As revealed in The Australian this week, the pay of many top public servants has soared by 70 per cent since the GFC, with some approaching earnings of $1 million at a time when growth in average earnings has slowed ­almost to a standstill.

·Richard Denniss

A retired bank CEO with $10 million in his super pays zero tax each year. Nada. Zip. He wouldn't even pay the Medicare levy. But I suspect that when Treasurer Scott Morrison talks about the "taxed and the taxed nots' he wasn't thinking about rich retired leaners. He probably wasn't even talking about the fact that Chevron, who made $1.7 billion selling our oil and gas, paid no tax either.

Having lost the public debate about the need to give $50 billion in tax cuts to big business, it didn't take Morrison long to dust off his predecessor's playbook on attacking the poor. Given how badly Joe Hockey performed some might think that aping his approach was a strange choice for Morrison, but, as Hockey's posting to Washington shows, the modern conservative party rewards rhetoric over results.

Sarah-Jane Tasker

The aged-care sector is set for heightened investor scrutiny as the major Australian listed operators report 2016 results, with the focus on funding models.

Investors will be closely looking at the outlook statements from listed operators Japara Healthcare, Regis and Estia Health given their share price performance in recent months has been disappointing — broadly falling between 20 per cent and 40 per cent.

The financial results from the industry, which begins with Japara today, will also give the first glimpse of the impact of government cuts to aged-care funding instruments.

Aged-care sector expert Ferrier Hodgson’s George Georges said in the new environment, where operator cost increases outweighed government funding increases, refreshed business models would be required.

Sean Parnell

A planned moratorium on new pathology collection centres — intended to give the Turnbull government time to settle a rental dispute with medical clinic landlords — has been scrapped.

It comes after Primary Health Care chief executive Peter Gregg last week revealed the threat of a moratorium had “changed the dynamics of the market” and prompted the company to fast-track additional collection centres.

Malcolm Turnbull announced the unexpected rent review during an election debate in May, with Pathology Australia agreeing to stop campaigning against the planned removal of Medicare bulk-billing incentives if the government helped address costs.

While the Department of Health had previously found no evidence that medical clinics were rent-gouging, the Liberals agreed to link “market value” to local commercial market rents and add compliance measures.

The federal government is hailing a new healthcare package as a revolutionary reform, but doctors and health groups warn it's set to fail unless Malcolm Turnbull invests more money in it.

The Health Care Homes program will keep chronically ill Australians out of hospital by changing the way doctors are paid.

Instead of the existing fee-for-service model which encourages high patient volumes because doctors are paid per consultation, the new model will remunerate GPs on a quarterly basis for the ongoing care of patients suffering chronic diseases such as diabetes.

Patients would enrol with a GP who becomes their care "home", coordinating all their care from psychologists to specialists.

Sarah-Jane Tasker

The price of pacemakers and ­replacement hips and knees is being blamed for Australia’s rising health insurance premiums, with such procedures costing up to three times as much as they do in Britain and Canada.

The head of Private Healthcare Australia, Rachel David, called on the Turnbull government yesterday to reform the Prostheses List — which the government uses to regulate how much health funds pay for prosthetics, human tissues and device implants — by the end of the year to enable premiums to be lowered next year.

Australians with private health insurance have endured premium rises of almost 6 per cent a year, which the industry argues could be curbed if prostheses prices are tackled.

“Our latest market ­research shows affordability of premiums is the biggest issue ... people are really hurting on this,” Dr David said.

Michael Roddan

NIB Holdings has been assisted by a slower increase in claims inflation over the year, booking a solid rise in annual profit and allowing chief executive Mark Fitzgibbon to flag smaller premium increases.

The health insurer (NHF) today booked a net profit of $92.9 million for the year through June, a 22 per cent increase year on year.

Profit was helped by a slowdown in claims inflation, which boosted the group’s margin from 13.3 to 14.9 per cent.

Revenue was up 13 per cent to $1.89 billion, and NIB said all divisions of its business were growing customer bases and improving earnings.

Sarah-Jane Tasker

Private health insurers have promised lower premiums next year, saving up to $150 per policy, if the Turnbull government cuts the price of medical devices, but the sector warns that reform must happen by November.

The industry has stepped up its campaign calling for reform of the Prostheses List — which the government uses to regulate how much health funds pay for prosthetics, human tissues and device implants — arguing there is a three-month window left to influence 2017 premiums.

Health Minister Sussan Ley, who ­announced a review of prostheses pricing in February, said yesterday the immediate priority was getting the new Prostheses List Advisory Committee up and running with the right expertise.

Kate Aubusson

The enticing extras offered with health insurance policies are being wasted by as many as two in three Australians with health insurance, a new survey suggests.

They're often the cherry on top of costly policies, but health insurance extras such as dental, optical, massage and other complementary therapies are often forgotten and left unused.

As many as 68 per cent of policyholders don't keep track of how much money their policy leaves them to claim on extras, according to the survey of more than 2000 people commissioned by comparison site Finder.com.au

Almost three in four Baby Boomers (over-55s) couldn't say what their extras allowance was, the survey found.

New research has revealed that the average cost of medical procedures in Australia doesn’t stack up when compared to what patients are paying elsewhere in the world.

According to the 2015 International Federation of Health Plans Comparative Price Report, Australian hospital patients are likely to be paying significantly higher operation charges than their counterparts in Britain and Canada, which could be the reason why you are paying so much for your health insurance premium.

Take for example a hip replacement. If you need one of those and are an Australian patient you could be looking at almost $27,500, but someone in Canada might only be paying $8,600.

What about a knee replacement? There’s a whopping difference there too. Aussie patients pay in excess of $23,000 but a Canadian patient is paying less than one-third of that at $7,589.

Liberal National MP George Christensen, who has threatened to cross the floor against Treasurer Scott Morrison's $6 billion crackdown on high-end superannuation concessions, has signalled that doubling the $500,000 lifetime cap would bring him back within the fold.

In a sign of how far restive backbenchers are demanding Mr Morrison go in winding back the Coalition's super plan, Mr Christensen said that lifting the cap to $1 million "would satisfy most concerns" over the government's policy.

Raising the lifetime non-concessional contributions cap would almost certainly wipe out most of the budget benefit from the $550 million measure and leave the Coalition wide open to opposition attacks that the government is demanding curbs to middle-class welfare while failing to share the pain on its wealthy political base.

Sarah Martin

Divisions within the government over superannuation reforms are deepening, as Scott Morrison prepares to retreat on key elements of the contentious $5.6 billion ­policy package before parliament resumes next week.

As Labor deflects pressure over its support for a $6bn omnibus savings bill by pointing to the government’s shifting superannuation policy, the Treasurer will meet a group of Coalition MPs today to try to strike a compromise deal on the budget measure.

During consultations with government backbenchers in the past week, Mr Morrison indicated that he is prepared to lift the cap on concessional contributions from $500,000 to $750,000, but a growing number of MPs say that is not enough to win partyroom support.

David Crowe

Sarah Martin

Liberal MPs are warming to Scott Morrison’s offer of a compromise on his tax increase on superannuation, as he tries to close a deal within weeks using an influential new backbench group to calm anger over the $6 billion policy.

The Treasurer outlined two ways to soften the tax hikes during hours of briefings in Canberra yesterday, securing more support for his overall policy even as he prepared to give ground on a divisive $500,000 lifetime cap on after-tax super contributions.

MPs told The Australian that a consensus was emerging in favour of increasing the cap to $750,000 rather than changing the start date for the threshold, which is meant to apply from July 2007. A key factor in the internal ­debate is the argument that ­increasing the cap will benefit ­current and future workers while dropping the 2007 start date would benefit only today’s cohort, who would only face tighter rules on new contributions rather than those they had made over the past decade.

Judith Sloan

Scott Morrison has embarked on the unusual task of trying to persuade fellow members of his own party in parliament to support his superannuation proposals announced at budget time.

It is exhausting stuff for a busy Treasurer — gosh, he has other things to do with his time rather than make the case for breaking an explicit promise not to impose higher taxes on superannuation.

But with the numbers so tight, he doesn’t have much choice lest a few parliamentarians decide that the Liberal Party should stand for lower taxation as well as keeping its word and vote against the legislation.

So I thought I would be helpful and provide a memo for the backbenchers (presumably, members of the ministry are locked into the suicidal superannuation proposals whatever their personal views may be) to help them sort the wheat from the chaff when Morro (we can be informal, surely?) comes calling to make his pitch.

Michael Roddan

The government’s overhaul of the $2 trillion super system appears to have frightened savers from pouring money into their retirement accounts, with official figures showing personal contributions fell by more than $800 million over the June quarter.

The drop in contributions may be one of the first signs that policy uncertainty is undermining con­fidence in the super system, says the Association of Superannuation Funds of Australia.

The latest figures from the Australian Prudential Regulation Authority, which regulates the ­financial industry, show personal super contributions slumped 11.3 per cent over the three months through June, down by $811m compared with the same period a year prior.

Grace Collier

According to a Coalition insider, years ago our federal treasurer at the time, Peter Costello, completely “stuffed up” our superannuation system. Until recently, this theory was completely unknown to me, and probably is news to you, too. You may have thought, as I did, that Costello was the last competent treasurer this nation had.

In any case, we were all wrong; apparently Costello was an irresponsible galoot. And unless our stuffed superannuation system is fixed, Scott Morrison said on radio this week, he will find it pretty hard to look his “kids in the eye and tell them they’ve got to saddle a higher debt because someone who had a very big income wanted to pay less tax”.

This “someone” with a “very big income” who wants to “pay less tax” is how the Treasurer refers nowadays to self-funded retirees. Earlier this month, he told listeners of radio station 5AA there were 6000 of them with superannuation balances of more than $5 million. One might expect a Liberal politician to praise these people, hold them up as role models and publicly thank them for staying off the public purse. After all, they have done exactly what various governments through many years have wanted them to do, and none of us will have to lift a finger to support them.